Fractured? Or just compromised?

This case was referred to our office for evaluation and expected extraction with eventual dental implant. Radiographically there was a large lesion associated with the mesial root, accompanying deep probing, and large swelling at the gingival margin. This case has several signs that would be consistent with non-restorable fracture. However, we used all available diagnostic tools, including CBCT, and could not definitively identify a fracture that would condemn the tooth to extraction. Therefore, we pursued retreatment with 6 weeks intracanal medicament. At the time of case completion, this patient was completely asymptomatic and the gingival tissue was healthy and firm. We have recommended to this patient’s restorative dentist that we follow-up this tooth for several months to see more radiographic evidence of bony healing before committing the patient to a new crown.